A boil, also called a furuncle, is a deep folliculitis, which is an infection of the hair follicle. It is most commonly caused by infection by the bacterium Staphylococcus aureus, resulting in a painful swollen area on the skin caused by an accumulation of pus and dead tissue.
Signs and symptoms
Boils are bumpy, red,
pus-filled lumps around a hair follicle that are tender, warm, and painful. They range from pea-sized to golf ball-sized. A yellow or white point at the center of the lump can be seen when the boil is ready to drain or discharge pus. In a severe infection, an individual may experience
fever, swollen
, and fatigue. A recurring boil is called chronic furunculosis.
Boils may appear on the buttocks or near the anus, the back, the neck, the belly, the chest, the arms or legs, or even in the ear canal.
Complications
The most common complications of boils are scarring and infection or abscess of the skin, spinal cord, brain, , or other organs. Infections may also spread to the bloodstream (bacteremia) and become life-threatening.[ S. aureus strains first infect the skin and its structures (for example, , ) or invade damaged skin (cuts, abrasions). Sometimes the infections are relatively limited (such as a stye, boil, furuncle, or carbuncle), but other times they may spread to other skin areas (causing cellulitis, folliculitis, or impetigo). Unfortunately, these bacteria can reach the bloodstream (bacteremia) and end up in many different body sites, causing infections (wound infections, abscesses, osteomyelitis, endocarditis, pneumonia)]
Causes
Bacteria
Naturally the cause is bacteria such as staphylococci that are present on the skin. Bacterial colonisation begins in the and can cause local cellulitis and inflammation.[ Myiasis caused by the tumbu fly in Africa usually presents with cutaneous furuncles.]
Family history
People with recurrent boils are as well more likely to have a positive family history, take antibiotics, and to have been hospitalised, anemic, or diabetic; they are also more likely to have associated skin diseases and multiple lesions.
Other
Other causes include Immunodeficiency such as from HIV/AIDS, diabetes, malnutrition, or alcoholism.[ Poor hygiene and obesity have also been linked.][
Boils which recur under the arm, breast or in the groin area may be associated with hidradenitis suppurativa (HS).]
Diagnosis
Diagnosis is made through clinical evaluation by a physician, which may include culturing of the lesion.
Treatment
A boil may clear up on its own without bursting, but more often it will need to be opened and drained. This will usually happen spontaneously within two weeks. Regular application of a warm moist compress, both before and after a boil opens, can help speed healing. The area must be kept clean, hands washed after touching it, and any dressings disposed of carefully, in order to avoid spreading the bacteria. A doctor may cut open or "lance" a boil to allow it to drain, but squeezing or cutting should not be attempted at home, as this may further spread the infection. Antibiotic therapy may be recommended for large or recurrent boils or those that occur in sensitive areas (such as the groin, breasts, armpits, around or in the nostrils, or in the ear).[ An antibiotic should not be used for longer than one month, with at least two months (preferably longer) between uses, otherwise it will lose its effectiveness.][ Mayo Clinic ]
Furuncles at risk of leading to serious complications should be incised and drained if antibiotics or steroid injections are not effective. These include furuncles that are unusually large, last longer than two weeks, or occur in the middle of the face or near the spine.[ Fever and chills are signs of sepsis and indicate immediate treatment.]
Staphylococcus aureus has the ability to acquire antimicrobial resistance easily, making treatment difficult. Knowledge of the antimicrobial resistance of S. aureus is important in the selection of antimicrobials for treatment.
See also
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Cutaneous condition
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Nodule (medicine)
External links
